The social distancing for my family started one week ago tomorrow. It was a Thursday afternoon. We probably should have been more aggressive, and started earlier, but we waited until after there were actually confirmed cases in Michigan before we made the call to keep the kids home from school and start working from home. I’m sure, looking back on the decision, we’ll regret having waited so long. We knew that the virus was probably out there, spreading through the community, but, like almost everyone else, I guess we were just in denial. And denial was relatively easy at that point, given that the administration of Donald “I don’t take any responsibility at all” Trump had so throughly botched the coordinated rollout of test kits. We didn’t get news that people around us were infected, because they weren’t being tested, and so we kept on living our lives.

Maybe we shied away from crowds a bit pre-lockdown, and wiped down the occasional doorknob, but we kept going to the gym, seeing friends, and eating out… But then the tests came. It was a week ago yesterday that we heard that we actually had confirmed cases here in Michigan. There were two at first. And, then, just like we knew that it would, the numbers began to grow exponentially, as testing spread, and as people infected over the previous weeks began to feel the effects of the illness and seek help. Today, according to WDIV in Detroit, the Michigan Department of Health and Human Services (MDHHS) is reporting that we have 110 confirmed cases. Here’s the chart showing the growth of confirmed cases thus far. The black dot in the bottom right, by the way, is our first COVID-19 death, which happened earlier today. [The man who passed away was in his 50s. According to reports, he had underlying health conditions.]

It’s sobering to look at, especially when you consider the fact that the trajectory we’re seeing here tracks pretty closely with what we saw in the early days of the Italian outbreak, where they’re now losing 475 people a day. [Italy’s population is six times Michigan’s, so our numbers likely won’t be as high, but the trajectory is still the same.] And we need to ready ourselves for the eventuality that, when we actually get the results back from this first wave of testing, we’ll discover that the virus is pretty much everywhere.

Yesterday, according to the New York Times, there were over 1,300 new cases of coronavirus diagnosed in the United States, and that’s with us still screening significantly fewer people than other developed nations. [Italy, a country of 60 million is now screening well over 10,000 people a day, whereas the United States, with 330 million people, was only testing about 2,500 a day up until a few days ago.] Here are two charts from the New York Times showing how we compare to other nations on the testing front.

And this, of course, is made worse by the fact that, even when people are being tested here, they aren’t receiving their results for several days. I have a friend here in Michigan, for instance, who was tested several days ago, and told that she’d have the results within 72 hours, a deadline which has long since come and gone, as she continues to wait in isolation.

I’d intended to go on, but it will have to wait for tomorrow.

Good night, my friends. Best of luck to you all.

update: While I had to stop for the night, an anonymous reader of this site, who works in the health care field here in Michigan, stepped in to pick things up where I left off. Here’s his comment.

You don’t need massive influx of cases to cause a problem. All it takes is a doubling of people who come to the hospital with viral pneumonia for a prolonged period of time, maybe from 2-3/day to 4-5/day for a moderate sized hospital. They have to be sorted into corona patients and non corona patients so that they can go into appropriate wards. The worst case is putting a corona patient into a non corona patient ward. Then you could end up with a Kirkland nursing home type outbreak.

The immediate problem is the sort. There are very few places where the test can be performed in a day. My state lab has backed up from 1-2 days to 2 days plus. The commercial labs have backed up from 3-5 days to 10 days plus. What do you do with the viral pneumonia patient now? You put them in the corona ward to be safe, where they will cause usage of masks whether they are truly a corona patient or not. After 3 days, test comes back negative. That patient is moved out. Meanwhile, the small bump in viral pneumonia patients continues. New patients are coming in, masks are in short supply, and test turnaround is increasing. The corona ward is expanded, making the other wards smaller. Car accidents, heart attacks, strokes, cancer, all is still happening.

At some point, testing is meaningless because after two weeks, patients have either gotten through the worst of it on their own or they are in really bad shape. That’s the problem.
It’s not a dramatic failure like an earthquake or flood. It’s more like termites or rust. It’s looks good from the outside until it doesn’t work, and then it falls apart slowly, then quickly, and there is nothing anyone can do…

For observant listeners and readers, the key immediate point is near the end. The special collection nasopharyngeal swabs needed for any testing is in short supply, being made in Italy. It won’t matter if tests are available if you can’t collect the material in a form that is acceptable for the test to run on